The DOJ’s Health Care Fraud Unit coordinated the investigation with the help of strike forces across the nation. Key aspects of the historical take down include the following:

• Enormous monetary scale: Again, the federal government alleges $14.6 billion in intended losses in total across the criminal cases. Law enforcement has already seized $245 million in cash, luxury vehicles, cryptocurrency, and assets from alleged fraudsters. The Centers for Medicare and Medicaid Services (CMS) also proactively prevented $4 billion in fraudulent payments, suspended billing privileges of 205 providers.
• Civil charges and settlements: In addition to criminal charges being levied, law enforcement has also sought civil penalties from other providers and medical professionals. This includes civil charges against 20 defendants for $14.2 million in alleged fraud, as well as civil settlements with 106 defendants totaling $34.3 million.
• Transnational criminal networks: A major component—Operation Gold Rush—alleges a global ring used foreign straw owners to submit $10.6 billion in false claims for durable medical equipment. Though CMS blocked all but ~$41 million in Medicare payouts, insurers received about $900  Individuals abroad and co-conspirators in the U.S. used encrypted messaging and assumed identities to facilitate the purchase of medical supply companies and subsequent fraud by exploiting the stolen identities of over one million Americans spanning all 50 states and using their confidential medical information to submit the fraudulent claims.
• Telemarketing/genetic testing schemes: One $703 million scheme involved deceptive telemarketing, AI-generated “consent” calls, and stolen Medicare IDs—all to bill labs and DME suppliers
• Wound-care fraud on vulnerable patients: Roughly $1.1 billion in fraudulent Medicare submissions for amniotic allografts were applied to terminally‑ill or hospice patients, without medical need or oversight
• Opioid prescription diversion: 74 defendants, including 44 medical professionals, are accused of diverting over 15 million pills (e.g., oxycodone, hydrocodone), feeding the illegal drug trade
• Genetic testing & telemedicine: At least 49 defendants were tied to over $1.17 billion in telemedicine/genetic testing fraud, a key enforcement focus of the Takedown.

These are just some of the schemes and methods alleged as health care fraud. Additional cases totaling approximately $1.84 billion involved medically unnecessary tests and treatments, kickbacks, and stolen controlled substances. DOJ’s Health Care Fraud Unit, along with FBI, HHS‑OIG, DEA, CMS, and state AGs, led this nationwide operation. The Government was able to leverage cloud computing, artificial intelligence, and advanced analytics to identify emerging health care fraud schemes. Specifically, a new Data Fusion Center used AI to spot suspicious billing patterns

Professionals in the medical industry could face disruptions based on these trends. Individuals could be criminally indicted despite a lack of financial gain for any peripheral involvement in these schemes. With over 205 providers with billing privileges already suspended or revoked, firms must evaluate billing practices and ensure compliance before audits or criminal actions escalate. Medical professionals and individuals in the industry should be proactive in address any potential problems. Assessing practices through comprehensive billing audits, tightening consent documentation and patient qualification protocols, and reviewing prescribing practices are key to ensuring compliance.

Given the unprecedented scope of this takedown, anyone involved in Medicare/Medicaid billing—especially in telemedicine, genetic testing, wound care, DME supply, opioid prescribing—should evaluate their practices now. Protecting your license, assets, and reputation hinges on early legal counsel, transparent operations, and robust documentation. Upon any contact from law enforcement, individuals should secure legal counsel immediately. The presumption of innocence matters, and charges are allegations—not convictions. Early intervention and strong representation can shift outcomes. Medical providers should document everything diligently. Medical necessity, patient consent, referrals, and codes must be in writing and defensible.

Even if charges carry potential fines or incarceration, negotiated resolutions mitigating those consequences are viable. At Conaway & Strickler, we are highly experienced in federal health care fraud cases. Contact us to discuss your situation confidentially—we’re here to protect your rights and your future.

Kousisis comes before the Court after a Philadelphia-area government contractor was found guilty of fraud after it failed to comply with a contract provision intended to promote diversity. Stamatios Kousisis and Alpha Painting and Construction Co., Inc. (Alpha) secured two substantial contracts with the Pennsylvania Department of Transportation (PennDOT). These contracts mandated a certain percentage of work to be allocated to Disadvantaged Business Enterprises (DBEs). Kousisis and his company misrepresented their compliance with this requirement by using a DBE as a mere pass-through entity, thereby falsely claiming adherence to the DBE participation goals. Despite this deception, the contracted work was completed to PennDOT’s satisfaction, and no direct financial loss was incurred by the department.

Federal prosecutors charged Kousisis and Alpha with wire fraud, conspiracy to commit wire fraud, and making false statements. The prosecution’s argument was based on the “fraudulent inducement” theory, suggesting that the defendants obtained the contracts through deceptive promises, even though PennDOT did not suffer a financial loss. Ultimately, Kousisis was sentenced to 70 months’ imprisonment for the multi-million dollar fraud he perpetrated following a jury trial in 2018.

However, the defense has argued that for a fraud conviction, there must be an intent to cause economic harm, which they claim was absent in this case. During oral arguments, Justice Ketanji Brown Jackson posed the question, “Why isn’t this a classic scheme to obtain property under false pretenses?” For years in federal white-collar cases, the “scheme” itself has always been recognized as the “harm” that triggers application of the federal fraud statutes. Despite that precedent, defense argued: “If there’s no harm that occurs in those transactions, there is no fraud.”

It seems that conservative justices were receptive to the defendant’s argument. Chief Justice John Roberts suggested that “such crimes were better handled by state prosecutors.” Justice Samuel Alito expressed that “the court really doesn’t like the federalization of white-collar prosecutions and wants that to be done in state court and is really hostile to this whole enterprise.”

The outcome of Kousisis v. United States holds the potential to redefine the scope of federal white-collar prosecutions. A decision favoring the defendants could lead to a substantial shift in prosecutorial responsibilities from federal to state authorities. A ruling that limits federal jurisdiction in such cases would compel companies to adapt by focusing more on state-level compliance and legal frameworks. Engaging with experienced legal counsel will be essential for businesses to remain compliant and mitigate risks in this evolving legal landscape.

Question: What types of issues come before the State of Georgia Nursing Board?

Answer: Below are some common issues the Board handles. Many of these issues may overlap, as most of this conduct also constitutes a crime.

1. Mishandling/misuse of drugs. This includes diverting medications intended for patients, taking medications for your own use, failing to document or inventory medications correctly, or submitting unauthorized prescriptions to pharmacies.
2. Sexual misconduct. This could include allegations of inappropriate sexual relationships with patients or sexually harassing colleagues.
3. Patient abuse or neglect. If a nurse physically, verbally, or mentally abuses a patient, or fails to provide them with timely or sufficient treatment, this could result in the loss of the nurse’s license.
4. Fraud. This may include allegations of falsifying patient records, misrepresenting credentials like education credits or diplomas, sending incorrect or inflated bills to insurance companies, etc.
5. Criminal convictions. Many convictions can disqualify nurses from practicing (such as driving under the influence or drug possession). Importantly, you can also lose your license if you do not disclose a past conviction (see below for more on the license renewal process).

Question: What happens when a complaint is filed against you?

Answer: If a complaint is filed against you with the board of nursing, the Board will review the complaint and open an investigation. If the allegations are serious, the board can issue an emergency temporary suspension of your license during the disciplinary process. Depending on the allegations, an investigator may be appointed to gather all necessary information, including documents, witness testimony, etc. The board may also ask you to submit a written response to the allegations in the complaint, along with any supporting evidence. The board will then decide whether there is enough evidence to support the allegations against you and move forward.

The Board may offer a consent order, allowing you to accept penalties without a formal hearing. The consent order typically involves admission to the wrongdoing and submitting to the disciplinary action recommended. If you decline, a formal hearing will be held, and disciplinary actions may follow. If no consent order is agreed to, you will be asked to appear at a formal hearing to defend yourself against the charges. After the hearing, the board will make a final determination. This could range from public reprimand to the suspension or revocation of your license. Even a minor disciplinary action can become a matter of public record, affecting your career and permanent reputation. It is critical to have a qualified attorney guiding you through this process.

Question: Why hire a nursing license defense attorney?

Answer: When a complaint is filed against you, the board of nursing does not consider you innocent until proven guilty, immediately putting you at a disadvantage. The Nursing Board’s primary goal is to protect the public, not defend nurses. With your career at stake, navigating the complexities of an investigation without legal assistance can be risky. Retaining a nursing license defense attorney ensures that your rights are protected, representing your best interests every step of the way.

Question: What if you are concerned about the license renewing process?

Answer: If you’ve been arrested or convicted since your last renewal, you need to proactively address these issues with the board. Building a mitigation packet and addressing any concerns early can significantly increase your chances of renewing your license without penalties. At Conaway & Strickle, PC, we are experienced in working with professionals to mitigate adverse Board actions related to arrests, substance abuse, and mental health issues. We can assist with not only getting your criminal case reduced or dismissed, but also renewing your license without sanctions.

Question: How can a DUI affect your nursing license in Georgia?

Answer: A DUI conviction in Georgia can result in probation and other penalties, such as random alcohol screenings, mental health evaluations, and restrictions on your nursing practice. These probationary conditions can last for years, depending on the severity of the case.

Below is a list of common probationary conditions that can be place on you following a DUI or an impaired driving under the influence of drugs charge in Georgia.

• Three years minimum probation (must be three years of continuous compliance, so the probationary period could be extended if you slip up)
• Psychotherapy Evaluation by a physician board certified in addiction medicine
• Psychotherapy Course of Treatment completion
• Quarterly Reports from Psychotherapist
• Mental and Physical Evaluation, with favorable finding pertaining to ability to perform duties
• Continuing Education Coursework
• Quarterly Reports from Employer
• Quarterly Reports from yourself
• Quarterly Reports from a Substance Abuse Treatment Aftercare program approved by the Board of Nursing
• Monthly PEth (blood alcohol) testing for first 12 months
• Bi-monthly random urine drug screens for duration of probationary period
• Random alcohol screens
• Enrollment in an Affinity Program, like the one offered by the Georgia Nurses Association
• Restrictions on nursing practice, often including an inability to practice in the following areas without prior Board of Nursing Approval: Agency/Pool Assignments; Private Duty Nursing; In-Home Nursing; Internal Float Pools; Travel Nursing; In-Home Hospice.
• Abstaining from alcohol, and mood-altering substances, including controlled substances unless prescribed.
• If prescribed any medication, providing a letter from the prescriber to both the Board of Nursing and the treatment/aftercare provider within 10-days of receiving such subscription.

Conclusion

If you’re facing challenges related to your nursing license, it’s important to act quickly. With the complexities of nursing board investigations and the potential damage to your reputation, having an experienced nursing license defense attorney is crucial. For more information, contact us today.

What is a Suspicious Activity Report (SAR)?

A Suspicious Activity Report (SAR) is a document that financial institutions are legally required to file with the Financial Crimes Enforcement Network (FinCEN) when they detect potentially suspicious behavior involving financial transactions. Once filed, these reports are sent to FinCEN, a division of the U.S. Department of the Treasury, which shares the information with law enforcement agencies for further investigation if necessary.

Why Do Banks File SARs?

Banks must comply with a variety of regulations designed to prevent financial crimes. One of the core elements of these regulations is monitoring customer transactions for anything that might indicate illegal or suspicious activity. A SAR is typically filed when a bank suspects that a transaction, or series of transactions, might involve:

• Money laundering: Attempting to disguise the origins of illegally obtained money by passing it through a legitimate banking system.
• Fraud: Including wire fraud, identity theft, and other deceptive financial activities.
• Structuring: Breaking down large sums of money into smaller deposits to avoid triggering reporting requirements (also known as “smurfing”).
• Unexplained large transactions: Transactions that don’t align with an individual’s or business’s typical activity or appear inconsistent with known financial patterns.

Common Triggers for SARs

Financial institutions are trained to spot red flags, and there are a number of scenarios that could trigger a SAR filing. Here are some of the most common:

1. Unusually Large Transactions: If an individual or business is suddenly moving unusually large amounts of money, especially in cash, this can raise red flags. Large deposits, withdrawals, or transfers that don’t align with normal activity patterns may prompt the bank to investigate further.
2. Frequent Cash Deposits Below $10,000: To avoid the $10,000 threshold that triggers an automatic Currency Transaction Report (CTR), some individuals break down larger sums into smaller deposits (a practice called structuring). If a bank detects this behavior, it will likely file a SAR.
3. Wire Transfers to High-Risk Countries: International wire transfers to or from countries that are known for terrorist activity, money laundering, or lacking robust financial regulations may result in a SAR filing.
4. Multiple Accounts Under One Name: Using multiple accounts to shuffle money back and forth—especially if the accounts seem unrelated to legitimate business or personal activities—can appear suspicious.
5. Account Activity Inconsistent with Known Business Practices: If a company typically processes small, regular transactions and suddenly starts handling large, irregular amounts, it might trigger suspicion. Likewise, if a personal account shows business-level activity, this could raise alarms.
6. Use of Shell Companies: Banks scrutinize accounts associated with shell companies that lack a clear purpose or business activity, as they are often used in money laundering schemes.
7. Unexplained Source of Funds: If the origin of deposited funds is unclear, or if large amounts of money are transferred without any legitimate explanation, the bank may file a SAR.

The Impact of a SAR Filing

When a bank files a SAR, it is confidential. The individual or business subject to the report is not directly informed; However, the bank may decide to take action based on its findings, which can include:

• Account closures: If the bank believes the activity is risky or potentially illegal, it may close your account or freeze any available funds.
• Increased monitoring: Your account may come under closer scrutiny, with more restrictions placed on transactions.
• Law enforcement involvement: If the behavior in question warrants it, the SAR could lead to a broader investigation by federal or state law enforcement agencies.

What to Do if You Believe a SAR Has Been Filed Against You

While you won’t be directly informed if a SAR has been filed, you may suspect something is amiss if your bank account is frozen, closed, or you’re contacted by law enforcement regarding your financial activity. If you find yourself in this situation, here are some steps to take:

1. Seek Legal Counsel: The most important thing you can do is consult with an experienced criminal defense attorney. A SAR filing could be the beginning of a serious investigation, and you’ll want legal guidance to protect your rights and interests.
2. Gather Financial Records: Be prepared to provide your attorney with all relevant financial records. This can help explain the nature of your transactions and demonstrate that they are legitimate.
3. Do Not Attempt to Explain Yourself to the Bank: Anything you say to the bank could be misinterpreted or used against you in a later investigation. Your attorney will be able to navigate these communications appropriately.

A Suspicious Activity Report can be a precursor to serious legal trouble, but it’s important to remember that it is not an accusation of a crime. Banks are required to report anything that appears suspicious, even if the behavior is ultimately lawful. If you find yourself facing consequences related to an SAR filing, don’t wait—contact us today for a consultation and take control of your situation before it escalates. If you are facing financial crime allegations, our skilled team of criminal defense attorneys is here to help.

Airports are high security environments with strict rules enforced through law enforcement, federal agents, TSA checkpoints, drug-sniffing dogs, US Marshals aboard flights, and more. Being arrested at an airport is overwhelming, scary, and often times, completely unexpected. However, the consequences of these arrest can be serious and long-lasting. An arrest at an airport could lead to detention by law enforcement, criminal charges, and the need to retain legal representation.

If you are arrested at an airport, you may be taken into custody and transported to a detention center or police station where you will be held and processed until further legal proceedings. However, this does not always happen at the airport – you may leave the airport and later have a warrant issued for your arrest. In that case, you would still need to turn yourself in for processing with law enforcement. In either circumstance, it is essential to remember your rights, including the right to remain silent and the right to legal counsel. Contacting an experienced criminal defense attorney will help you navigate that distressing process with an advocate by your side.

Airport arrests can lead to severe criminal charges depending on the circumstances of your case. Common criminal charges in this context cover a broad range including drug offenses, sexual offenses, firearm offenses, DUIs, disorderly conduct, battery, theft, trafficking, and fraud. You could also be arrested at the airport for entirely unrelated criminal charges if you are simply identified and apprehended pursuant to an active arrest warrant, such as this recent arrest in Atlanta. Committing crimes while aboard an aircraft (like interfering with the performance of the duties of a flight crew) can lead to federal criminal charges and even more severe penalties. Many of these charges carry significant terms of imprisonment and hefty fines.

A strong legal defense is crucial if you have been arrested at an airport or are under investigation for alleged conduct at an airport. A skilled criminal defense attorney will guide you through the process, explain the charges against you, and evaluate the evidence to develop a defense strategy tailored to your case.

At Conaway and Strickler, we craft a defense based on the unique circumstances of each case and work closely with our clients to pursue favorable resolutions. If you have been arrested or detained at an airport, it is important to hire an attorney that is experienced in this area of law and can safeguard your rights throughout each step of the process. Contact us for a free consultation regarding your case.

These types of schemes originated in 2020 and have gained international momentum through the use of social media platforms and online dating applications. In a departure from conventional financial scams, these fraudsters focus on psychological manipulation of victims by crafting elaborate fake identities to establish romantic or emotional connections with their targets.

After the scammer creates a fake online persona, the scam begins by initiating contact with a target. Often, the scammer will pretend to have stumbled across a “wrong number” as they contacted the victim. The next step is starting a conversation with a potential victim to gain their trust. The scammers often initiate benign chats about life, family, and work, and they’ll fabricate details about their own life that make them seem similar to you. Once the scammer gains trust, they will eventually pivot the conversation to investing and making claims about their own purported success with investments.

Once the target agrees to accept “help” with the investment process, the scammer typically explains how to wire money from their bank account to a crypto wallet and eventually to a “brokerage.” The scammer may initially encourage a modest investment and allow the victim to withdraw “returns” on their investment as proof the investment is legit. From there, the scammer will only continue to manipulate their victim into investing more and more. Once the fraudster is unable to convince the victim to continue making deposits, they will disappear and sever all contact.

A key feature that distinguishes pig butchering scams is the human aspect that shows a pattern of coercion and exploitation. Often times the low-level operators of these scams are victims themselves who may have been coerced into participating in these crimes under the guise of employment opportunities. Many of the perpetrators are lured from abroad then forced to commit the fraud by organized crime syndicates. The effects of pig butchering scams extend beyond the significant financial losses to encompass human rights issues tied to trafficking and coercion.

Perpetrators of pig butchering scams have been charged across the country by federal prosecutors working alongside the Computer Crime and Intellectual Property Section’s (CCIPS) National Cryptocurrency Enforcement Team (NCET), which was established to combat the growing illicit use of cryptocurrencies and digital assets. In California, four defendants were charged with conspiracy to commit money laundering, concealment money laundering, and international money laundering for their involvement in a $20 million dollar pig butchering scheme.

Pig butchering scams were discussed in a recent episode of Last Week Tonight with John Oliver. As the episode highlights, these scams are increasingly common and the losses to victims can be devastating.

Money Laundering refers to the illegal process of concealing the origins of money obtained through criminal activities, making it appear as if it comes from a legitimate source. This is criminalized under 18 U.S.C. § 1956. Money laundering using NFTs involves the illicit use of these digital assets to disguise the origins of illegally obtained funds. In this context, individuals create a fake record of sales on the blockchain by selling NFTs to themselves using different accounts. Once finished, they sell the NFT to an unsuspecting buyer and repeat the process.

Fraud has grown increasingly common in the crypto landscape due to its anonymous and decentralized nature. Fraud involving NFTs can manifest in various ways due to the unique characteristics of these digital assets. This is mostly being prosecuted as wire fraud under 18 U.S.C. § 1343. Some common forms of fraud associated with NFTs include:

1. Fake or Stolen NFTs: Fraudsters might create counterfeit NFTs by copying digital content and attempting to sell them as original or rare pieces. Additionally, they might steal someone else’s artwork or content and mint NFTs to sell without the creator’s consent.
2. False Representation: Individuals might misrepresent the ownership or authenticity of an NFT by falsely claiming it is associated with a particular creator or source, leading buyers to believe they are purchasing something of higher value or legitimacy than it actually holds.
3. Pump-and-Dump Schemes: Similar to traditional financial markets, some individuals may engage in pump-and-dump schemes within the NFT market. This involves artificially inflating the value of certain NFTs through false hype or manipulation, only to sell them off at a high price, leaving unsuspecting buyers with devalued assets.
4. Phishing and Scams: Scammers may use phishing techniques to trick NFT owners into providing their private keys or access to their digital wallets, allowing the fraudster to steal the NFTs. Additionally, fraudulent schemes and fake NFT marketplaces can deceive buyers and sellers into making transactions for non-existent or misrepresented NFTs.
5. Rug-Pull Scheme: As the term suggests, a “rug pull” refers to a scenario where the creator of an NFT and/or gaming project solicits investments and then abruptly abandons a project and fraudulently retains the project investors’ funds.

Law enforcement is continuing to prosecute these types of NFT schemes across the nation, in cases that allege millions of dollars being defrauded. Two defendants were charged for executing a $1 million NFT money laundering and fraud scheme in January 2022. In another NFT rug-pull, Aurelien Michel was charged for diverting $2.9 million dollars in an international fraud scheme.

Under proposed USSG 4C1.1, a client will receive a 2-level decrease to their offense level if a)no criminal history points,

b)did not receive a terrorism adjustment under §3A1.4

c)did not use violence or threats of violence,

d) did not cause death or serious injury,

e) did not commit a sex offense,

f) did not cause any victim substantial financial hardship,

g) did not possess or use a firearm or deadly weapon,

h) did not violate a victim’s civil rights,

i) did not commit a hate crime, an adjustment under §3A1.1 , and

j) did not receive an aggravating role adjustment pursuant to Chapter 3 of the USSG.

Also, another related amendment provides in Application Note 4 (A) to §5C1.1 “that a sentence other than imprisonment is generally appropriate” for a client in Zone A or B after a §4C1.1 reduction

Under proposed USSG 5C1.1, a non-custodial sentence is “generally appropriate” for a Zero-Point Offender in Zone A or B of the Sentencing Table. For reference, the highest range for a Zero-Point offender in Zone B is 8-14 months imprisonment. For Zero-Point offenders outside of Zone A and B, however, subsection (b) to 5C1.1 suggests a downward departure, including to probation, for Zero-point offenders if the applicable Guidelines range “overstates the gravity of the offense because the offense of conviction is not a crime of violence or an otherwise serious offense.”

Long and short, there is a more of a possibility to get probation in less complex fraud cases now.

Contact contact us to get more details.